Busulfan, Etoposide, and Total-Body Irradiation in Treating Patients Undergoing Donor Stem Cell or Bone Marrow Transplant for Advanced Hematologic Cancer

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of 1 of the following:
• •* Acute myeloid leukemia (AML)
• •* Failed remission induction therapy or in relapse beyond second remission
• •* In first remission with poor risk cytogenetics (e.g., 11q abnormalities, -7, -5, complex abnormalities \[i.e., \> 3 abnormalities, 6;9 translocation and 3q abnormalities del (7q), del (5q), complex abnormalities ≥ abnormalities, 9q, 20q, 21q, 17q, t(9;21)\])
• •* Acute lymphoblastic leukemia (ALL)
• •* Failed remission induction therapy or in relapse beyond second remission
• •* Blastic phase chronic myelogenous leukemia
• •* Refractory anemia with excess blasts
• •* Refractory anemia with excess blasts in transformation
• •HLA -A, -B, -C, -DR identical sibling donor match available
• •No relapse after prior bone marrow transplantation
• •PATIENT CHARACTERISTICS:
• •Cardiac ejection fraction ≥ 50%
• •Serum creatinine ≤ 1.2 times upper limit of normal (ULN) or creatinine clearance \> 80 mL/min
• •Bilirubin ≤ 1.5 times ULN
• •AST and ALT \< 5 times ULN
• •FEV\_1 ≥ 50% of predicted normal
• •DLCO ≥ 50% of predicted normal
• •No psychological or medical condition that would preclude allogeneic transplantation (in the opinion of the treating physician)
• •Not pregnant
• •Negative pregnancy test
• •PRIOR CONCURRENT THERAPY:
• •See Disease Characteristics
• •At least 28 days since prior induction or reinduction therapy
• •Prior etoposide and busulfan allowed
• •No prior radiation therapy that would exclude total-body irradiation